The competencies below are drawn from Knowledge and Competency Standards for Specialized Cognitive Behavior Therapy for Adult Obsessive-Compulsive Disorder, published in Psychiatry Research in 2021. The standards were developed by the International OCD Accreditation Task Force, a 14-nation group of experts convened by the Canadian Institute for Obsessive Compulsive Disorders, to establish measurable knowledge and competencies for specialized OCD treatment. They provide a framework clinicians can use to identify areas for growth and find resources within the Training Center to build their knowledge and skills.
Please note - as indicated, the competencies were developed specifically for OCD. This Hub includes resources for the related disorders as well, mapped on to their approximate correlates within the OCD competencies. Until such time that specific competencies for each related disorder exists, we will continue adding resources in this way.
| Competency Domain |
Core Competencies |
- OCD Assessment
|
Conduct comprehensive diagnostic assessment; differentiate OCD from related disorders; assess severity, impairment, insight, risk, and comorbidities; use validated OCD measures; identify symptom dimensions and functional impact. |
| 2. Case Conceptualization |
Develop individualized cognitive-behavioral formulations; identify maintaining mechanisms (obsessions, compulsions, avoidance, safety behaviors, maladaptive beliefs); use formulation to guide treatment planning and revise as treatment progresses. |
| 3. Psychoeducation |
Explain OCD models and treatment rationale; normalize intrusive thoughts and uncertainty; reduce shame and stigma; provide education tailored to symptom presentation, culture, and developmental context. |
| 4. ERP & Behavioral Experiments |
Design individualized exposure hierarchies; implement in-session and between-session exposures; prevent rituals and safety behaviors; maximize inhibitory learning; monitor and troubleshoot ERP implementation, Design experiments that test feared predictions and dysfunctional beliefs; gather corrective learning through direct experience; strengthen treatment engagement and insight. |
| 5. Cognitive Therapy for OCD |
Identify and address obsessive beliefs, including inflated responsibility, threat overestimation, perfectionism, intolerance of uncertainty, thought-action fusion, and importance/control of thoughts; integrate cognitive strategies with ERP |
| 6. Family-Based Interventions |
Assess family accommodation; educate family members about OCD; reduce accommodation and reassurance; support caregiver involvement in treatment and ERP implementation |
| 7. Homework and Between-Session Practice |
Assign structured ERP and cognitive exercises; monitor adherence; address barriers to completion; promote generalization of learning outside therapy sessions. |
| 8. Symptom-Specific Intervention Skills |
Adapt treatment for contamination, checking, harm obsessions, taboo thoughts, incompleteness/"not-just-right" experiences, mental rituals, reassurance seeking, hoarding features, and overvalued ideation. |
| 9. Management of Treatment-Interfering Behaviors |
Address avoidance, nonadherence, reassurance seeking, covert rituals, poor motivation, and other obstacles to treatment engagement; use motivational and collaborative strategies. |
| 10. Cultural Knowledge and Adaptations |
Incorporate cultural, religious, and contextual factors into assessment and treatment; distinguish OCD symptoms from culturally normative practices; adapt interventions while maintaining treatment fidelity. |
| 11. Relapse Prevention |
Develop individualized relapse-prevention plans; identify early warning signs; strengthen self-monitoring skills; prepare for future symptom recurrence; support long-term maintenance of gains. |
| 12. Comorbidity Management |
Assess and manage common co-occurring conditions; understand how depression, anxiety disorders, trauma, personality factors, and neurodevelopmental conditions affect treatment planning and outcomes. |
